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Equity–Efficiency Trade-offs in Healthcare System Reform: The Perspective of Tiered Diagnosis and Treatment in China 医疗体制改革中的公平-效率权衡：中国分级诊疗的视角
IF 2.9 2区 经济学
China & World Economy Pub Date : 2025-05-15 DOI: 10.1111/cwe.12592
Daisheng Tang, Zhen Zhang, Xinyuan Wang, Tao Bu, Qiushi Feng
{"title":"Equity–Efficiency Trade-offs in Healthcare System Reform: The Perspective of Tiered Diagnosis and Treatment in China","authors":"Daisheng Tang,&nbsp;Zhen Zhang,&nbsp;Xinyuan Wang,&nbsp;Tao Bu,&nbsp;Qiushi Feng","doi":"10.1111/cwe.12592","DOIUrl":"https://doi.org/10.1111/cwe.12592","url":null,"abstract":"<div>\u0000 \u0000 <p>Efforts to reform healthcare systems globally have long been driven by the inherent tradeoffs between equity and efficiency. Using a patient referral model, we constructed a cost– benefit matrix for both hospitals and patients. We analyzed the effects of nominal tiered diagnosis and treatment (TDT) using medical institutions' monthly report data from Sichuan province spanning 2012 to 2018. Additionally, we assessed the effects of actual TDT based on inpatient medical records data from Sichuan province spanning 2015 to 2018. We further discussed the potential for the TDT model to achieve Pareto improvements in addressing equity–efficiency trade-offs in healthcare. Our findings suggest that nominal TDT failed to improve patients' medical behaviors. In contrast, actual TDT improved medical efficiency by enhancing patient outcomes and reducing the relative length of hospital stay, while also promoting medical equity by narrowing disparities in out-of-pocket expenses and health insurance reimbursements. Moreover, the effects of actual TDT on efficiency and equity varied across hospital types, disease categories, and inpatient populations. Actual TDT has the potential to generate Pareto improvements in managing the equity–efficiency trade-offs within the healthcare system. Strengthening actual referral behaviors proved crucial for fully realizing the benefits of the TDT model.</p>\u0000 </div>","PeriodicalId":51603,"journal":{"name":"China & World Economy","volume":"33 3","pages":"150-196"},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cwe.12592","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Digital Inputs, Information Transparency, and Global Supply-Chain Security 数字输入、信息透明和全球供应链安全
IF 2.9 2区 经济学
China & World Economy Pub Date : 2025-05-15 DOI: 10.1111/cwe.12588
Jijun Yang, Qi Guo, Feng Dai, Jinlan Ni
{"title":"Digital Inputs, Information Transparency, and Global Supply-Chain Security","authors":"Jijun Yang,&nbsp;Qi Guo,&nbsp;Feng Dai,&nbsp;Jinlan Ni","doi":"10.1111/cwe.12588","DOIUrl":"https://doi.org/10.1111/cwe.12588","url":null,"abstract":"<p>This study examined the impact of digital inputs on global supply-chain security. Using data from the Asian Development Bank Multiregional Input–Output database, covering 62 countries or regions and 35 industries from 2007 to 2022, digital inputs were found to enhance the level of supply-chain security significantly. In times of crisis prevention, digital inputs not only improved supply-chain security but also contributed to a notable recovery effect. Mechanism tests indicated that digital inputs enhanced supply-chain security mainly by improving information transmission efficiency and increasing both demand-side and supply-side information transparency. Heterogeneity analysis indicated that all three mechanisms were significant in the manufacturing sector, but demand-side information transparency was not significant in the service sector. Further analysis identified post and telecommunications sector as having the greatest positive impact on supply-chain security.</p>","PeriodicalId":51603,"journal":{"name":"China & World Economy","volume":"33 3","pages":"1-32"},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can Environmental, Social, and Governance Performance Promote the Participation of Emerging Economies in Multinational Supply Chains? 环境、社会和治理绩效能否促进新兴经济体参与跨国供应链？
IF 2.9 2区 经济学
China & World Economy Pub Date : 2025-05-15 DOI: 10.1111/cwe.12587
Dianfan Yu, Xin Li, Chao Wang
{"title":"Can Environmental, Social, and Governance Performance Promote the Participation of Emerging Economies in Multinational Supply Chains?","authors":"Dianfan Yu,&nbsp;Xin Li,&nbsp;Chao Wang","doi":"10.1111/cwe.12587","DOIUrl":"https://doi.org/10.1111/cwe.12587","url":null,"abstract":"<p>Multinational companies are increasingly recognizing the importance of integrating social responsibility initiatives into their business models as a means of building a sustainable competitive advantage. This study uses data from Chinese A-share listed companies spanning from 2009 to 2020 to conduct an empirical analysis. The findings indicate that strong environmental, social, and governance (ESG) performance facilitated firms' integration into global supply chains. This effect was particularly pronounced among firms in heavily polluting and labor-intensive industries, and those located in provinces with weaker institutional environments and underdeveloped industrial structures – regions often associated with greater ESG-related identity challenges. The positive impact of ESG performance was also more evident in firms that supplied listed companies or operated closer to end consumers, due to increased public scrutiny. Mechanism analysis revealed that ESG performance served as a signaling tool by enhancing information transparency and building reputational capital. Further analysis showed that ESG performance not only supported firms' entry into host countries with stronger institutional environments but also contributed to longer lasting supply chain relationships. This article provides new insights into how emerging economies could integrate into the international supply chain system more effectively.</p>","PeriodicalId":51603,"journal":{"name":"China & World Economy","volume":"33 3","pages":"33-75"},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Creating Cities and Urban–Rural Income Dynamics: Evidence from County-to-District Transformation in China 创建城市与城乡收入动态：来自中国县区转型的证据
IF 2.9 2区 经济学
China & World Economy Pub Date : 2025-05-15 DOI: 10.1111/cwe.12589
Wenhui Chen, Xinyan Hu
{"title":"Creating Cities and Urban–Rural Income Dynamics: Evidence from County-to-District Transformation in China","authors":"Wenhui Chen,&nbsp;Xinyan Hu","doi":"10.1111/cwe.12589","DOIUrl":"https://doi.org/10.1111/cwe.12589","url":null,"abstract":"<p>Classical development economics theories offer conflicting perspectives on the relationship between urbanization and urban–rural income gaps (URIG). This study examined the impact on URIG of county-to-district transformation (CDT), a Chinese government-led urbanization strategy. Using county-level panel data from 2000 to 2022, the analysis found that CDT promoted county-level economic growth, resulting in absolute income gains for both urban and rural residents. However, urban incomes grew at a faster rate, widening the relative income gap. This gap-widening effect was primarily driven by urban-biased land allocation and fiscal expenditure preferences, with a more pronounced effect in areas that were farther from the city government and smaller in scale. Agricultural support measures could mitigate this trend. Dynamic analysis revealed that the impact of CDT on URIG followed a short-term expansion and long-term convergence trend. These findings provide new evidence regarding urbanization and income disparity and offer policy insights for the promotion of inclusive growth through urbanization in developing countries.</p>","PeriodicalId":51603,"journal":{"name":"China & World Economy","volume":"33 3","pages":"109-149"},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Historical Clans and Contemporary Human Capital 历史氏族与当代人力资本
IF 2.9 2区 经济学
China & World Economy Pub Date : 2025-05-15 DOI: 10.1111/cwe.12591
Yao Wang, Zhecong Zheng, Dawei Feng
{"title":"Historical Clans and Contemporary Human Capital","authors":"Yao Wang,&nbsp;Zhecong Zheng,&nbsp;Dawei Feng","doi":"10.1111/cwe.12591","DOIUrl":"https://doi.org/10.1111/cwe.12591","url":null,"abstract":"<p>This study examines the long-term impact of historical clan strength on contemporary human capital development in China. Our findings reveal that historical clan strength had a significant positive effect on individual human capital, particularly in rural households, even after accounting for confounders and robustness checks. We observe that clan culture complemented the implementation of compulsory education in shaping contemporary educational outcomes. Mechanism analysis suggests that clan strength motivated parents to prioritize their children's education and increased the likelihood of low-income individuals receiving financial assistance from relatives and friends. However, we find no evidence that clan strength affected the allocation of public educational resources. These findings highlight the enduring role of cultural transmission mechanisms in human capital formation and underscore the importance of incorporating cultural factors into the design of educational policies.</p>","PeriodicalId":51603,"journal":{"name":"China & World Economy","volume":"33 3","pages":"234-270"},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rewards and Costs of Being a Mother: Motherhood and Women's Mental Health in China 做母亲的回报与代价：母性与中国妇女心理健康
IF 2.9 2区 经济学
China & World Economy Pub Date : 2025-05-15 DOI: 10.1111/cwe.12586
Xiangpo Chen
{"title":"Rewards and Costs of Being a Mother: Motherhood and Women's Mental Health in China","authors":"Xiangpo Chen","doi":"10.1111/cwe.12586","DOIUrl":"https://doi.org/10.1111/cwe.12586","url":null,"abstract":"<p>Women's well-being has gained increasing importance in global health agendas. This study employed longitudinal data from 36,144 women in China from 2010 to 2018 to investigate the impact of motherhood on women's mental health. Using a model that incorporated interactions between time trends and individual and household characteristics, the study revealed that women with newborns generally reported higher levels of mental well-being. However, those with toddlers aged 3–6 were more likely to experience symptoms of depression. The impact of motherhood on mental health was shaped by the interplay between the emotional benefits linked to hormonal changes and the emotional costs associated with childcare obligations. Access to supportive childcare services can help women alleviate the stresses of maternal responsibility, thereby enhancing their mental well-being. When adequate resources are available, motherhood may not pose significant challenges to women's mental health.</p>","PeriodicalId":51603,"journal":{"name":"China & World Economy","volume":"33 3","pages":"271-294"},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tax–Debt Substitution? Local Government Debt Management and Corporate Tax Burden 税收债务替代?地方政府债务管理与企业税负
IF 2.9 2区 经济学
China & World Economy Pub Date : 2025-03-27 DOI: 10.1111/cwe.12576
Yixuan Tan, Jianjun Li, Fanghui Li
{"title":"Tax–Debt Substitution? Local Government Debt Management and Corporate Tax Burden","authors":"Yixuan Tan,&nbsp;Jianjun Li,&nbsp;Fanghui Li","doi":"10.1111/cwe.12576","DOIUrl":"https://doi.org/10.1111/cwe.12576","url":null,"abstract":"<p>The Local Debt Management System Reform, introduced in 2014 and implemented in subsequent years, was a key initiative by the Chinese government to mitigate local government debt risks. Using its implementation as a natural experiment, this study examined its impact on corporate tax burdens. The results indicated that tighter debt constraints significantly increased corporate tax burdens, as local governments intensified tax collection to offset reduced debt-related revenue. This effect was stronger in areas that were reliant on land financing and less economically developed. Further analysis revealed that, rather than reducing expenditure, local governments sought alternative revenue sources, including urban investment bonds, land transfer income, and public–private partnership projects. These findings illuminate local fiscal behavior under debt constraint and provide insights for the design of institutional frameworks aiming to manage local debt risks.</p>","PeriodicalId":51603,"journal":{"name":"China & World Economy","volume":"33 2","pages":"252-282"},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Industrial Robot Adoption, Human Capital, and Global Value Chain Upgrading: Insights from China 工业机器人采用、人力资本与全球价值链升级：来自中国的洞察
IF 2.9 2区 经济学
China & World Economy Pub Date : 2025-03-27 DOI: 10.1111/cwe.12575
Tianding Zhang, Sumei Gan
{"title":"Industrial Robot Adoption, Human Capital, and Global Value Chain Upgrading: Insights from China","authors":"Tianding Zhang,&nbsp;Sumei Gan","doi":"10.1111/cwe.12575","DOIUrl":"https://doi.org/10.1111/cwe.12575","url":null,"abstract":"<p>Concerns have been raised that the adoption of industrial robots in developed economies may hinder industrialization and displace jobs in emerging economies. However, the growing use of robots in emerging economies may help mitigate these negative effects. This study, drawing on a theoretical model and empirical analysis, reveals that the adoption of robots in China, a developing country, significantly enhanced firms' positions in global value chains (GVCs). A detailed analysis reveals that markups and the structure of intermediate inputs were key mechanisms. The study also found that improvements in human capital enhanced the efficiency of robots, enabling firms to use them more effectively, which further strengthened the firms' position in GVCs. The positive impact of the adoption of robots on GVC upgrading was more pronounced in non-resource-based cities and cities with high labor costs. Furthermore, the study highlights that robot adoption in medium- and high-tech industries had a greater impact on GVC upgrading. In conclusion, this study suggests that robot adoption in emerging economies can enhance their position in GVCs, with human capital playing a crucial role.</p>","PeriodicalId":51603,"journal":{"name":"China & World Economy","volume":"33 2","pages":"209-251"},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trade Theories in the Digital Age 数字时代的贸易理论
IF 2.9 2区 经济学
China & World Economy Pub Date : 2025-03-27 DOI: 10.1111/cwe.12581
Yongjin Wang, Wenbin Wang
{"title":"Trade Theories in the Digital Age","authors":"Yongjin Wang,&nbsp;Wenbin Wang","doi":"10.1111/cwe.12581","DOIUrl":"https://doi.org/10.1111/cwe.12581","url":null,"abstract":"<p>The digital economy is overtaking the industrial economy and reshaping every subfield of economics. As a result, widely accepted conclusions and policy implications of international trade theories are becoming outdated. This paper endeavors to delineate some of the potential directions in which digital technologies may disrupt and overturn traditional trade theories. It also provides frameworks that enable the conceptualization and analysis of international trade in the digital age. The advance of digital technology has given rise to novel industries and numerous supporting infrastructures and has instigated a fundamental transformation of traditional industries. This transformation is evident across multiple dimensions, including factors of production, product attributes, production technology, market structures, business models, and consumer search behaviors.</p>","PeriodicalId":51603,"journal":{"name":"China & World Economy","volume":"33 2","pages":"1-40"},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can Quality and Safety Demonstration Zone Policy Lower Nontariff Barriers? Evidence from Sino–US Food and Agricultural Trade 质量安全示范区政策能降低非关税壁垒吗？以中美食品和农产品贸易为例
IF 2.9 2区 经济学
China & World Economy Pub Date : 2025-03-27 DOI: 10.1111/cwe.12579
Rui Xiao, Genyuan Zhong, Xifang Ma
{"title":"Can Quality and Safety Demonstration Zone Policy Lower Nontariff Barriers? Evidence from Sino–US Food and Agricultural Trade","authors":"Rui Xiao,&nbsp;Genyuan Zhong,&nbsp;Xifang Ma","doi":"10.1111/cwe.12579","DOIUrl":"https://doi.org/10.1111/cwe.12579","url":null,"abstract":"<p>Technical regulations and product standards are increasingly hindering international food and agricultural trade, particularly for developing countries. This paper examines the impact of China's place-based agricultural policy – specifically, the establishment of quality and safety demonstration zones for exported food and agricultural products – on reducing the disparity in product standards between China and the US. Using panel data for Chinese cities between 2009 and 2017, this study employed a difference-indifferences approach and found that the policy significantly reduced the incidences of US import refusals related to China's exported products. Mechanism analysis suggests that adoption of new production technology was the primary driver of this improvement, narrowing the technical gap between the two countries. The findings offer actionable insights for developing countries seeking to address nontariff barriers and improve food and agricultural exports to developed markets.</p>","PeriodicalId":51603,"journal":{"name":"China & World Economy","volume":"33 2","pages":"65-97"},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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